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Acute cor pulmonale due to lymphocytic interstitial pneumonia in a child with AIDS

Sandra Fagundes Moreira-Silva1, Linda Marly C Moreno, Mariana Dazzi

  • 1Hospital Estadual Infantil Nossa Senhora da Glória, Vitória, Espírito Santo, Brazil. sandrafagundesmoreira@gmail.com

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|June 26, 2012
PubMed

Insights

Acute cor pulmonale in a child with HIV developed lymphocytic interstitial pneumonia. Treatment with HAART and chloroquine resolved pulmonary hypertension and right-heart enlargement.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Pulmonology

Background:

  • Acute cor pulmonale presents as right-sided heart failure due to increased pulmonary vascular resistance.
  • Human immunodeficiency virus (HIV) infection can lead to complex cardiopulmonary manifestations in children.

Observation:

  • A 5-year-old HIV-infected male presented with respiratory distress, fever, and cough.
  • Imaging revealed ground-glass opacities, cystic lesions, and bronchiectasis, indicative of lymphocytic interstitial pneumonia (LIP).
  • Echocardiography confirmed acute cor pulmonale with pulmonary hypertension and right-heart chamber dilation.

Findings:

  • The patient was diagnosed with Acquired Immunodeficiency Syndrome (AIDS)-B3, LIP, and acute cor pulmonale.
  • A 30-day course of highly active antiretroviral therapy (HAART) and chloroquine therapy led to regression of pulmonary hypertension and right-heart chamber dimensions.

Implications:

  • This case highlights the potential for acute cor pulmonale in pediatric HIV/AIDS patients with LIP.
  • Early diagnosis and combined antiretroviral and specific therapies can reverse cardiopulmonary complications.
  • Consideration of AIDS and LIP is crucial in children presenting with recurrent pneumonia, differentiating it from cystic fibrosis.
Abstract

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